Abstract |
Nonmyeloablative stem cell transplantation in patients with follicular lymphoma has been designed to exploit the graft-versus- lymphoma immunity. The long-term effectiveness and toxicity of this strategy, however, is unknown. In this prospective study, we analyzed our 8-year experience. Patients received a conditioning regimen of fludarabine (30 mg/m(2) daily for 3 days), cyclophosphamide (750 mg/m(2) daily for 3 days), and rituximab (375 mg/m(2) for 1 day plus 1000 mg/m(2) for 3 days). They were then given an infusion of human leukocyte antigen-matched hematopoietic cells from related (n = 45) or unrelated donors (n = 2). Tacrolimus and methotrexate were used for graft-versus-host disease (GVHD) prophylaxis. Forty-seven patients were included. All patients experienced complete remission, with only 2 relapses. With a median follow-up time of 60 months (range, 19-94), the estimated survival and progression-free survival rates were 85% and 83%, respectively. All 18 patients who were tested and had evidence of JH/bcl-2 fusion transcripts in the bone marrow at study entry experienced continuous molecular remission. The incidence of grade 2-IV acute GVHD was 11%. Only 5 patients were still undergoing immunosuppressive therapy at the time of last follow-up. We believe that the described results are a step forward toward developing a curative strategy for recurrent follicular lymphoma.
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Authors | Issa F Khouri, Peter McLaughlin, Rima M Saliba, Chitra Hosing, Martin Korbling, Ming S Lee, L Jeffrey Medeiros, Luis Fayad, Felipe Samaniego, Amin Alousi, Paolo Anderlini, Daniel Couriel, Marcos de Lima, Sergio Giralt, Sattva S Neelapu, Naoto T Ueno, Barry I Samuels, Fredrick Hagemeister, Larry W Kwak, Richard E Champlin |
Journal | Blood
(Blood)
Vol. 111
Issue 12
Pg. 5530-6
(Jun 15 2008)
ISSN: 1528-0020 [Electronic] United States |
PMID | 18411419
(Publication Type: Clinical Trial, Phase II, Journal Article)
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Chemical References |
- Antibodies, Monoclonal
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Agents
- Myeloablative Agonists
- Rituximab
- Cyclophosphamide
- Vidarabine
- fludarabine
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Topics |
- Adult
- Aged
- Antibodies, Monoclonal
(administration & dosage, adverse effects)
- Antibodies, Monoclonal, Murine-Derived
- Antineoplastic Agents
(administration & dosage, adverse effects)
- B-Lymphocytes
(cytology)
- Combined Modality Therapy
- Cyclophosphamide
(administration & dosage, adverse effects)
- Female
- Follow-Up Studies
- Graft vs Host Disease
- Graft vs Tumor Effect
- Hematopoietic Stem Cell Transplantation
- Humans
- Lymphoma, Follicular
(drug therapy)
- Male
- Middle Aged
- Myeloablative Agonists
(administration & dosage, adverse effects)
- Prospective Studies
- Recurrence
- Remission Induction
- Rituximab
- Survival Rate
- Transplantation Chimera
- Transplantation Conditioning
(methods)
- Transplantation, Homologous
- Vidarabine
(administration & dosage, adverse effects, analogs & derivatives)
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